Procedure: Patient is brought in the operating room. Advised to lie in prone position with pillow under abdomen. Patient is sedated with intravenous sedation if needed. Skin and subcutaneous tissue is anesthetized with local anesthesia. Local anesthesia used is lidocaine 1%. Lidocaine injected using 23 G needle. Total volume use is 2 to 3 ccs.

Procedure is performed using image intensifier (portable x-ray machine). Antero-posterior, lateral and oblique view use for needle placement.Live intermittent and continuous x-ray pictures are view.

Needle is placed under anesthesia in front of aorta. Two Needles are place on each side: right and left side.X-ray antero-posterior and lateral view is used for placing needle tip over celiac plexus. Aspiration test is performed to check aspiration of blood.

Dye study indicates dye is spreading in linear fashion in cephalic and caudal direction on both side.Antero-posterior view and lateral (side) view is checked to confirmed the dye spread.

Celiac Plexus Block:

Aspiration test is performed to check needle placement in blood vessels.Medications injected at each side once all test are indicating needle is not in blood vessel.20 ccs of 0.5% Marcaine injected on each side. Needle gently removed.